“NEUROTROPIC” VITAMINS B1, B6, B12 AND DIABETIC NEUROPATHY (literature review)
DOI:
https://doi.org/10.21856/j-PEP.2025.1.08Keywords:
vitamin B1, vitamin B6, vitamin B12, diabetes mellitus, diabetic neuropathy, diabetic peripheral neuropathy, reviewAbstract
Optimizing treatment strategies for diabetic neuropathy, with a particular focus on peripheral neuropathy (DPN), continues to represent a significant area of unmet clinical need. The evidence supporting the use of various medications, derived from systematic literature reviews and expert insights, often remains inconclusive. Currently, numerous studies and clinical guidelines aim to rationalize the clinical use of these treatment resources. A deficiency in “neurotropic” vitamins B1, B6, and B12 may contribute to the development of diabetic neuropathies. These vitamins play crucial roles in fostering conditions that promote successful nerve regeneration, each serving unique functions within the nervous system. Vitamins B1, B6, and B12 are essential for maintaining normal neurological functions due to their distinct biochemical mechanisms of action, particularly as coenzymes, and they can be effectively combined in the treatment of DPN. Vitamin B1 is especially necessary as a cofactor in glucose metabolism and, therefore, indirectly supports the synthesis of nucleic acids, neurotransmitters, and myelin, and provides energy for these processes. Additionally, vitamin B1 is thought to play a role in antioxidant mechanisms, acting as a localized antioxidant. Vitamin B6 serves as a coenzyme in the synthesis of neurotransmitters essential for synaptic transmission. The neuroprotective effects of vitamin B6 are based on its importance for the glutamatergic system. Vitamin B12 plays a critical role in the survival of neurons and is directly involved in the synthesis and maintenance of the myelin sheath through remyelination. Thus, the “neurotropic” vitamins B1, B6, and B12 are likely to have a synergistic effect on the function of various biochemical pathways in the nervous system, including the peripheral nervous system. Future clinical trials must consider these vitamins as therapeutic and neuroprotective options for DPN, as well as for certain central nervous system disorders. However, the molecular mechanisms by which these vitamins act are not yet fully understood, necessitating further research. Additionally, more in vitro and in vivo experimental studies exploring the individual and combined effects of vitamins B1, B6, and B12 are required to clarify their molecular mechanisms, demonstrate their neuroregenerative functions, and assess their neuroprotective capabilities. The purpose of this review was to discuss the role of the “neurotropic” vitamins B1, B6, and B12 in the prevention and treatment of DPN, as well as to analyze new trends and directions for future research.
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